Summaries of health policy coverage from major news organizations

Insurers Often Refuse Coverage For Injuries Sustained In Illegal Activities

The New York Times examines how some patients who are never charged with a crime can have their health claims denied by insurers because they reportedly were hurt while engaging in an illegal act. Meanwhile, The Washington Post looks at the large hospital bill one California man received after a dangerous snake bite.

The New York Times' Well Blog:
‘Illegal Activity’ Fine Print Leaves Some Insured, But Uncovered
[A]s he lay in the hospital hooked to a ventilator, Mr. Bird’s insurance company declined to cover his medical bills. The reason? His injuries resulted from “illegal activity.” Yet Mr. Bird was not convicted of any crime in connection with the incident. He was not even charged. ... Insurers have long relied on allegations of illegal activity to deny coverage to patients injured in a variety of contexts, from traffic infractions to gun accidents. (Rabin,7/20)

The Washington Post's Wonkblog:
This $153,000 Rattlesnake Bite Is Everything Wrong With American Health Care
Earlier this month a guy named Todd Fassler was bitten by a rattlesnake in San Diego, KGTV San Diego reports. In itself this isn't terribly unusual—the CDC estimates that roughly 7,000 to 8,000 people a year get bit by a venomous snake in the U.S. And somewhere between five and six people die from these bites each year. What raised eyebrows, though, was Fassler's hospital bill—all $153,000 of it. KGTV reporter Dan Haggerty shared it on Twitter. ... The bulk of his hospital bill—$83,000 of it— is due to pharmacy charges. Specifically, charges for the antivenin used to treat the bite. ... There's currently only one commercially-available antivenin for treating venomous snakebites in the U.S. -- CroFab, manufactured by U.K.-based BTG plc. And with a stable market of 7,000 to 8,000 snakebite victims per year and no competitors, business is pretty good. (Ingraham, 7/20)

In other insurance news -

The Connecticut Mirror:
CT Insurance Customers Urge Regulators To Reject Rate Hikes
The insurance department published comments on three companies’ proposed rate hikes in advance of next Monday’s public hearing on the proposals. Anthem is seeking to raise rates by an average of 4.7 percent on plans that cover 55,000 people, while ConnectiCare is seeking a 9.8 percent rate hike for plans that cover 34,400 people. Golden Rule, which covers 3,414 people, has proposed an 18.5 percent rate increase. (Levin Becker, 7/20)

Kaiser Health News:
More Health Plan Choices At Work. What’s The Catch?
Until recently, John Henry Foster, an equipment distribution firm based in Eagan, Minn., offered its employees only a couple of health plans to choose from. That’s common in companies across America. “They just presented what we got,” says Steve Heller, a forklift operator who has worked at John Henry Foster for 15 years. But these days the company’s employees have dozens of choices. And something else is new: Each worker now receives money from the company (from $350 to $1,000 a month, depending on whether Heller and his co-workers are buying insurance for a single person, a couple or a family) to buy a health plan. (Zdechlik, 7/21)

USA Today:
Bartiromo: AthenaHealth's CEO Talks Health Care, Tech And Cousin Jeb Bush
Health care was one of the few industries that saw job creation in the month of June because of a revolution going on in the industry. We are living longer, getting in front of disease and monitoring everything from our fluids and heart rate to our digital records. All of this as premiums are going up and the Supreme Court rules the Affordable Care Act will stay the law of the land. I caught up with one of the leaders in this new marriage between health care and technology: AthenaHealth CEO Jonathan Bush who is providing cloud-based services for electronic health records, revenue management, and other point-of-care apps that are changing the way we approach health care. I also asked him about his first cousin who is hoping to occupy the White House in 2017. (Bartiromo, 7/20)

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